Gastric variceal haemorrhage successfully managed by splenectomy--a case report and literature review.

Figure Diagrammatic representation ofoperative findings demonstrating a 6 cm inflammatory mass in the pancreatic tail with gastric vein dilatation. laparotomy. Prominent veins around the gastric fundus and splenomegaly were noted. An anterior gastrotomy revealed two large bleeding gastric varices which were oversewn. A total of 30 units of blood had been transfused to this point. On the tenth post operative day she had a further significant bleed and was transferred to our unit for further management. A second laparotomy was performed and the previously noted gastric fundal venous dilatation and splenomegaly were confirmed. A cystic inflammatory mass was identified in the tail of the pancreas while the liver appeared grossly normal. The pancreatic cyst was deroofed and a splenectomy performed. Histology of the cyst revealed chronic inflammation and no evidence oftumour. She has remained well without further bleeding.